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Fourth Annual Report B.C. Hospital Insurance Service JANUARY 1ST TO DECEMBER 31ST 1952 British Columbia. Legislative Assembly 1953

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Full Text

 PROVINCE OF BRITISH COLUMBIA
"HOSPITAL INSURANCE ACT"
Fourth Annual Report
B.C. Hospital Insurance
Service
JANUARY 1st TO DECEMBER 31st
1952
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1953  r
E. C. Martin.
B.C. Hospital Insurance Service,
Victoria, B.C., February 3rd, 1953.
To His Honour Clarence Wallace, C.B.E.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Fourth Annual Report of the B.C.
Hospital Insurance Service covering the calendar year 1952.
E. C. MARTIN,
Minister of Health and Welfare. mm
L. F. Detwiller.
(
B.C. Hospital Insurance Service,
Victoria, B.C., February 3rd, 1953.
The Honourable E. C. Martin,
Minister of Health and Welfare,
Parliament Buildings, Victoria, B.C.
Sir,—I have the honour to present herewith the Report of the B.C. Hospital
Insurance Service covering the calendar year 1952.
Respectfully submitted.
L. F. DETWILLER,
Commissioner, B.C. Hospital Insurance Service. CONTENTS
Page
Introduction  7
Coverage and Eligibility  7
Premium Rates  7
Organization and Administration  7
Payroll Division  7
Central Accounts Division  8
Tabulating Division  8
Field Representative Division  9
Registration and Exemption Claims  10
Exemption Claims Section  10
Record Section  10
Dependency Claims Section  10
Soundex Index Section  10
Departmental Comptroller  10
Hospital Services Group—
Hospital Claims Division  11
Hospital Accounting Division  11
Method of Payment to Hospitals  11
General Hospital Care   12
B.C.H.I.S. Patients and Patient-days, 1952  13
Hospital Consultation and Inspection Division, Victoria  13
Hospital Consultation and Inspection Division, Vancouver __._  13
Research Division  14
Hospital Construction Division   15
Statement of Revenue Receipts and Disbursements for the Fiscal Year Ended March
31st, 1952  16
Statement Showing Cash Reconciliation with the Public Accounts of the Province of
British Columbia as at March 31st, 1952  17
Table Ia.—Patients Discharged and Days of Care in B.C. Public Hospitals, 1949-52,
and Proportion Covered by B.C. Hospital Insurance Service  18
Table Ib.—Percentage of Patients Covered by B.C. Hospital Insurance Service during
1952  18
Table Ha.—Patients Discharged, Total Days' Stay, and Average Length of Stay
According to Type and Location of Hospital, and Days of Care per Thousand
of Covered Population for B.C.H.I.S. Patients Only, Years 1949 to 1952  18
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and Short-stay
Patients, 1949 to 1952  19
Table III.—Patients Discharged, Total Days' Stay, and Average Length of Stay in
B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According to Bed
Capacity, Year 1952  19
Table IV.—Percentage Distribution of Patients Discharged and Patient-days for
B.C.H.I.S. Patients Only, in B.C. Public Hospitals, Grouped According to Bed
Capacity, Year 1952  19
Benefits in B.C. Hospitals, 1952  20
Classes of Persons Covered by or Excluded from the Benefits of the Hospital Insurance Service . .  21
Benefits in Hospitals outside British Columbia  21
5  Fourth Annual Report of the B.C. Hospital
Insurance Service
(b)
(c)
(d)
INTRODUCTION
The most significant administrative change made in the Hospital Insurance Service
during its fourth year of operation was the elimination of the quarterly cyclical method
of premium billing and payment, and the reintroduction of the semi-annual system of
billing and payment for all persons who pay premiums directly to the Service.
Other major changes affecting the administration of the plan included: —
(a) The broadening of the dependency regulations to allow persons to claim
brothers and sisters as dependents.
The elimination of previous co-insurance charges and the introduction of
the dollar-a-day plan.
A reduction of $3 per year in the premium rate for all persons.
The suspension of premium arrears for the years 1949, 1950, and 1951.
During 1952 the Service paid 189,761 hospital bills on behalf of beneficiaries.
Since the Hospital Insurance Service commenced  operation on January   1st,   1949,
850,000 hospital bills have been paid, totalling more than $70,000,000.
Coverage and Eligibility
All residents of British Columbia must register for hospital insurance and must pay
premiums, unless they have been granted an exemption. Every person who has registered
and paid premiums, in the prescribed manner, is entitled to receive benefits under the
"Hospital Insurance Act."
A detailed description of persons who are entitled to claim exemption from premium
payment is contained on page 21, and a full description of the benefits is given on page 20.
Premium Rates
Up until June 30th, 1952, premium rates were $30 per annum for single persons and
$42 per annum for the head of a family with one or more dependents. After June 30th
the premium rates were reduced to $27 for single persons and $39 for the head of
a family.
There are two principal methods of premium payment: —
(1) Payroll Deduction.—The premiums of persons employed by firms participating in the Payroll Deduction Plan are deducted each month from their
wages.
Direct Payment.—Persons paying premiums direct are billed from Victoria
and pay premiums on a semi-annual basis.
ORGANIZATION AND ADMINISTRATION
(2)
The activities and achievements of the Service's various departments are recorded
in the succeeding paragraphs.
Payroll Division
On December 31st, 1952, 3,700 firms were registered for payroll deductions and
making monthly salary deductions of the premiums of their employees. Two hundred
and five thousand registrants are now paying their premiums monthly through the Payroll
Deduction Plan.   Employers on the plan are billed monthly for standard deductions, for NN 8
BRITISH COLUMBIA
any premium arrears owing by their employees, and for any amounts required to prepay
their employees' premiums six months in advance.
A special staff of payroll field representatives, in Vancouver, continued to advise
and assist employers in the administration of the Payroll Deduction Plan and to register
new firms for payroll deductions.
Regional representatives, located strategically throughout the Province, maintained
local contact with employers in their areas and spent a large proportion of their time on
work for the Payroll Division.
Central Accounts Division
In January, 1952, Direct Payment Division held 130,000 accounts on a three-month-
cycle billing basis, and Central Accounts Division held 180,000 accounts on a six-month
billing basis.
During April, 1952, these accounts were merged for administrative purposes into
one Central Accounts Division. The two billing systems operated side by side until
June, when the major task of converting the 130,000 quarterly billing accounts to a six-
month billing basis commenced. This task was completed in October, and now the
310,000 accounts held in the Division are billed on a standard six-month basis. All of
these accounts were billed during November, 1952, for the six-month period January 1st
1953, to June 30th, 1953.
Other major tasks undertaken by the Division during the year included the adjustment of all accounts brought about by the reduction in premium rates, which, during
August, was made retroactively effective to July 1st, 1952, and the suspension of
outstanding 1949, 1950, and 1951 premium arrears.
A total of 2,000,000 billings, letters, and remittances was processed during the year.
Tabulating Division
This Division operates I.B.M. electric accounting equipment employing punch-cards.
During the year the following regular work was performed:—
The preparation of monthly group billings for 205,000 registrants on payroll
deduction.
The maintenance of controls and the processing of 75,000 cash and journal entries
per month for 310,000 registrants whose accounts are held in Central Accounts Division.
The preparation of two complete semi-annual billings for direct-paying registrants
and two arrears billings for delinquents. HOSPITAL INSURANCE SERVICE REPORT,  1952 NN 9
The weekly preparation of hospital remittance lists, billings to municipalities for the
per diem grant, and statements to patients for income-tax purposes, for a total of 189,761
hospital accounts submitted during the year. Statistical reports covering these accounts
were prepared on a monthly basis.
In addition, the following major projects were completed:—
More than 900,000 cards, representing registrants and dependents, were coded,
punched, and verified by the key-punch section at the beginning of the year. These cards
were sorted to the order of the Russell Soundex Code and then listed on individual strips
for the Soundex Index.
The 130,000 quarterly cyclical accounts held on punched cards by Direct Payment
Division were transferred to Central Accounts Division semi-annual billing system over
a three-month period.
The premium rates for nearly 500,000 accounts held by both Central Accounts
Division and Payroll Division were changed by the accounting-machines when the
premium rate was reduced in August.
Arrears prior to 1952 were suspended. The machines scanned some 310,000
accounts and calculated the amount of arrears to be suspended for each delinquent
registrant.
Two hundred thousand name and address cards were prepared for all Payroll
Division registrants, and these were added to the master address file.
Field Representative Division
Effective January 1st, 1952, the entire field organization of the Service was
consolidated for administrative purposes into the Field Division.
Under the Provincial Field Supervisor, Victoria, who is responsible for the supervision and direction of all field offices and collection agencies, and the issuance of all
deduction orders pursuant to the " Hospital Insurance Act," this Division is organized
as follows:—
City collection offices: The Service maintains collection offices where premiums
may be paid in Vancouver, New Westminster, Chilliwack, and Victoria.
Twelve regional representatives are located throughout the Province. Each representative works within a designated territory and inspects firms on payroll deduction,
carries out collection proceedings for persons in arrears, and handles public inquiries,
complaints, and conducts investigations as directed.
Thirty-seven Government Agencies accept premium payments from the public and
deal with inquiries of a general nature.
Seven commission agencies operating on a commission basis—six located in Fraser
Valley communities and one at Trail—accept premium payments from the public and
deal with inquiries of a general nature.
During the year two new collection procedures were developed:—
(1) Arrears settlement and suspension procedure: This procedure provides
a uniform method of granting benefits upon payment of the current
premium:—
(a) While outstanding premium is being paid by monthly instalments; or
(b) By the full suspension of arrears, where the registrant is unable
to pay more than the current premium.
(2) Non-payroll procedure:   This procedure provides:—
(a) A method of identifying employed and delinquent registrants
in places of employment; and
(b) A system of issuing deduction orders to the employers pursuant
to the "Hospital Insurance Act." NN  10 BRITISH COLUMBIA
Registration and Exemption Claims
This Division contains four sections: Soundex Index, Exemption Claims, Records
Files, and Dependency Claims.
The most important change in the Division was the creation of a 1,000,000-line
index, in which the names of all persons registered for British Columbia hospital insurance
are filed according to the Russell-Soundex coding system.
Exemption Claims Section
During the year this Section approved 49,902 claims for exemption. The number
of exemptions granted under the various classifications is as follows:—
Social assistance  28,384
Department of Veterans' Affairs     6,781
Royal Canadian Mounted Police and armed services     8,036
Provincial institutions      1,538
Christian Scientists     1,633
Exempted areas         301
General exemptions         147
Telephone   Employees'   Medical   Services   Association   of
British Columbia      3,900
Canadian Pacific Employees' Medical Association of British
Columbia   14,000
Total  64,720
Record Section
This Section is responsible for the filing and maintenance of 657,342 original
registration forms and the recording of births, deaths, marriages, cancellations, changes
of status and employment on these registration forms. During the year 445,580 changes
were recorded.
Dependency Claims Section
This Section reviews all applications received from registrants claiming relatives who
are financially dependent on the registrant by reason of physical or mental infirmity.
A total of 2,338 applications was received during 1952.
Soundex Index Section
In April, 1952, this Section assumed responsibility for maintaining and operating
the new Soundex Index, through which all unidentified correspondence, forms, etc., are
channelled for identification by registration number.
During the nine months since its introduction, 116,891 items were checked to the
Soundex Index, and adjustments to it necessitated by marriages, deaths, and new
registrations averaged 11,000 per month.
A total of 48,938 new applications for registration under the "Hospital Insurance
Act " was received during the year.
DEPARTMENTAL COMPTROLLER
All revenue is channelled through this Division, where it is checked, audited, and
allocated to control accounts. The Division controls, audits, and analyses expenditures.
An internal audit of the Service and of collection agencies was undertaken during 1952.
The Departmental Comptroller's office is also responsible for the receipt, dispatch,
and distribution of mail;   the preparation of statements of revenue and expenditure, HOSPITAL INSURANCE SERVICE REPORT,  1952
NN  11
hospital payments, personnel, and exemptions; the supervision of the accounting operations for the three Provincial Infirmaries and the financial transactions of the " Hospital
Construction Act " and Fund; and the operation of the Equipment and Supplies Section,
which maintains furniture and equipment inventories as well as inventories of forms,
stationery, and other supplies.
HOSPITAL SERVICES GROUP
Hospital Claims Division
The main functions of this Division are to advise hospitals of patients' eligibility and
to process hospital accounts for payment. Approximately 750 admission notices and an
equal number of hospital accounts are received daily for checking and processing.
Admission forms are screened for diagnosis, and the patient's eligibility status is
then determined. Advice is sent to hospitals on each admission received with regard to
B.C.H.I.S. responsibility for the patient's account.
During the year 189,761 hospital accounts were approved for payment. Included
in this total were 2,943 out-of-Province accounts, paid on behalf of beneficiaries admitted to hospitals in all parts of Canada, United States, Central and South America, and the
majority of European countries.
This Division also controls the billing and collection of municipal per diem grants.
Individual hospital accounts were checked to determine the municipality responsible,
and billings were subsequently dispatched to each municipality showing the total amount
due.
The previous year's records—over 600,000 documents—were microfilmed, to
effect a considerable savings in filing space and equipment.
During past years, hospital-insurance premiums for persons in receipt of welfare
funds were- paid to B.C. Hospital Insurance Service by the Welfare Branch of the Provincial Department of Health and Welfare. From April 1st, 1952, the Claims Division
paid hospital accounts for this group and then billed and recovered the actual cost from
the Welfare Branch.
Hospital Accounting Division
This Division is primarily concerned with hospital budgets, maintaining close working relations with the hospitals, and the inspection of hospital accounting records.
Frequent inspections are made of hospital financial and statistical records. Where smaller
hospitals have changes in accounting staff, and local assistance is not available, this
Division has, upon request, sent accountants to write up the hospital's books and to train
new staff.
Monthly statistical reports and statements of revenue and expenditure are received
from hospitals and compared with the approved budgets, and advance payments are calculated and made semi-monthly.
The Annual Hospital Report and annual statistical and financial reports, as well as
reports required by the Dominion Bureau of Statistics, are prepared by this Division.
In addition, requests for payment of grants in connection with capital expenditures made
by hospitals for equipment are studied and recommended for approval. Audits of
accounts relating to hospital-construction projects are carried out by this Division in
collaboration with Dominion Treasury officials.
Method of Payment to Hospitals
Effective January 1st, 1951, a system of fixed or firm budgets was instituted. Under
this system, hospital budgets submitted were reviewed by the Rate Board of the Hospital
Insurance Service, and after such adjustments as were found necessary, the resulting
budgets were established.   A similar procedure was followed in 1952.   Hospitals were NN  12
BRITISH COLUMBIA
advised that, with the exception of certain items (particularly fluctuation in days' treatment), they would be required to live within their approved budgets, and that deficits
which were incurred through expenditures, in excess of the approved budget, would not
be met. Calculations were made to determine the value of variable supplies used in the
care of patients. The budgets were subject to adjustment upward or downward by the
number of days by which the actual experience differed from the estimate, multiplied
by the patient-day value of the variable supplies. In the relatively few instances where
the fluctuations were sufficiently great to entail additions to or reductions in stand-by
costs, individual studies were made and budget adjustments established.
Due to the fact that all hospitals treat a certain number of non-B.C.H.I.S. patients
(Workmen's Compensation Board, transients, non-insured individuals, and persons
exempt from hospital-insurance coverage by reason of membership in the Canadian
Pacific Railway and B.C. Telephone medical plans), the Service is not responsible for
the entire patient-load. The Service, therefore, pays to each hospital each month the
portion of one-twelfth of the yearly budget that is represented by the B.C.H.I.S. insured
days as compared to the total days' treatment. Remittances to hospitals are made twice
monthly. At the end of any month each hospital has been paid the approximate amount
of its earnings to date by B.C.H.I.S. patients, including those remaining in hospital at the
end of the month. Effective August 9th, 1952, all insured patients were required to pay
$1 for each day's hospitalization. The co-insurance charges of $2 to $3.50 a day, for
the first ten days' hospitalization of a family unit during a year, were at the same time
cancelled. The $1 a day collectable from insured persons is deducted in calculating
payments due to hospitals from the Service.
Hospitals collect from non-insured persons at established per diem rates.
General Hospital Care
Statistical data dealing with the volume of hospital care provided to the population
of British Columbia by the Service are presented in the tables on the following pages.
Seventy-eight public hospitals are approved to accept B.C.H.I.S. patients. In addition,
a proportion of care has been given in the Province's licensed private hospitals, including
company-operated hospitals in remote areas. The private-hospital classification in the
tables also includes Red Cross outpost units and the veterans' hospitals at Vancouver
and Victoria.
The 1952 data given have been prepared from preliminary unrevised reports submitted by the hospitals of the Province and are subject to minor revision. HOSPITAL INSURANCE SERVICE REPORT,  1952 NN  13
B.C.H.I.S. Patients and Patient-days, 1952
The average length of stay of B.C.H.I.S. adult and children patients in British
Columbia public hospitals increased from 9.77 days in 1951 to 10.16 days in 1952.
The total adult and children days covered by B.C. Hospital Insurance Service in British
Columbia public hospitals were 1,568,740 during 1952, an increase of 101,638 or
7 per cent over 1951.
A total of 154,353 B.C.H.I.S. adult and children patients was discharged from
British Columbia public hospitals during 1952, an increase of 4,237 or 2.8 per cent
over 1951.
Hospital Consultation and Inspection Division, Victoria
During 1952 this Division continued its efforts to help hospitals with their administrative problems and to assist the other divisions of the Service. Staff members made a
number of regular visits to hospitals, of from one day to one week in duration. Several
special visits were made at the request of hospitals.
The personnel advisory service to hospitals, formerly provided by the Personnel
Office, was established in the Division, and information on personnel matters was distributed to hospitals.
A dietary consultant service for hospitals was arranged with the Health Branch. In
response to requests, the nutrition consultants of the Health Branch made several visits
during the year.
A medical-record manual, intended especially for use by hospitals that do not have
a trained medical-record librarian, was compiled. The manual was put into use in one
hospital on a test basis and will be reproduced for general distribution as soon as it has
proved to be satisfactory.
This Division helped with the review of hospital estimates and was represented on
the Rate Board. The staff also helped with the study of hospital plans, requests for
equipment grants, and examination of revised by-laws submitted by hospital societies.
Information on the day-to-day utilization of beds in the Greater Vancouver and New
Westminster areas was assembled throughout the year.
Hospital Consultation and Inspection Division, Vancouver
A hospital consultation and inspection service, the licensing and inspection of
private hospitals, the hospital-clearance programme, and screening applications for
admission to the Provincial Infirmary were carried on by the Vancouver office during
1952. The same close liaison was maintained with the Social Welfare Branch. Investigations were made and service given in matters referred to other divisions of the Hospital
Insurance Service.
During the year 1952 there were 408 problem cases referred by general hospitals
throughout the Province, for whom request for removal from hospital was made and
which involved referral to and investigation by the Social Welfare Branch.
There were 138 applications for admission to the Provincial Infirmary received and
considered.   Of these, 128 were recommended for Infirmary admission.
There were forty-three inquiries made regarding the establishment of private hospitals. Of these, one was with respect to a private mental hospital. There were five new
private-hospital licences issued and four private hospitals closed during the year. One
private-hospital licence was revoked.
There were sixty-four inquiries received which concerned situations where hospitals
or persons were requesting service as to procedure involving other departments of the
Government, but which did not pertain to either hospital clearance or private hospitals.
While some of these inquiries were directed to the Hospital Insurance Service, they were
not, upon investigation, necessarily hospital-insurance problems and were therefore, in
turn, referred to the agency or department responsible for the case-handling. NN  14
BRITISH COLUMBIA
An annual visit of an inspectional nature was made to all licensed private hospitals.
In addition, complaints received with respect to the operations of any private hospital
were thoroughly investigated. Interpretation and guidance were given to private hospitals
upon request, and, as a result, a large number of the private hospitals were visited a
number of times during the year. There have been more visits made to the office of the
Inspector of Hospitals by owners of private hospitals this year than heretofore.
These visits have been for the purpose of discussing proposed alterations and improvements and higher standards of care, diversional programmes, and administrative
practices generally.
This Division continued to administer the " Mental Hospitals Act," sections 6 and 7.
Research Division
This past year the Division maintained monthly progress reports, compiled statistics
concerning hospitalization experience, and conducted special studies on matters related
to the Service.
In addition, data were made available to various branches of the Service to aid in
answering queries from the public and to assist in dealing with routine operational
problems.
During the year the groundwork was laid for the preparation of analytical studies in
the medical-statistics field. The first major project, an analysis of morbidity statistics, is
scheduled for 1953, and the Division is planning to devote more of its time to conducting
research in this field.
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Hospital Construction Division
The primary function of this Division is to render an advisory or consulting service
to hospitals or hospital groups contemplating building improvements, reconstruction,
additions to existing structures, or the construction of a new hospital. Reference material
on the planning and construction of hospitals is available, and is loaned upon request to
interested groups.
In 1951 an effort was made to secure up-to-date plans of all the hospitals in the
Province, and plans for the majority of the hospitals in the Province are now available in
Victoria. Reviews of plans have been completed, and detailed reports made to the
hospitals for nine major projects and seventeen projects involving improvements and
alterations.
During the year, payments based upon progress certificates submitted by hospitals
undertaking construction projects amounted to $3,357,160, which would represent a
gross expenditure of approximately $5,372,400.
The Division also advises hospitals and hospital groups of the financing formulae of
the Federal and Provincial Governments and outlines in detail the conditions that are
attached to their financial assistance. Federal and Provincial grants became available to
hospitals only following the approval of the project in principle and a detailed review of
the plans by the Hospital Insurance Service. The review is made with particular attention
being paid to ensuring that the design will permit quality of care, efficient and economical
operation, and adequate provision for expansion. Specifications and contract documents
are also submitted to this Service for review.
This Division acts on behalf of the Federal Government to ensure that its minimum
standards are met. This includes ensuring that the plans satisfy the Provincial Fire
Marshal, and that minimum floor areas, corridor-widths, and adequate services exist.
L NN  16 BRITISH COLUMBIA
STATEMENT OF REVENUE RECEIPTS AND DISBURSEMENTS FOR THE
FISCAL YEAR ENDED MARCH 3 1st, 1952
Revenue receipts—
Premiums—
General    $ 15,302,705.79
Social assistance        1,406,551.75
► 16,709,257.54
2,360,464.93
Municipal per diem grants         $933,370.73
Provincial per diem grants         1,427,094.20
$19,069,722.47
Cash disbursements—
Administration—
Salaries      $ 1,385,695.98
Advisory Council  247.29
Advertising and publicity   49,193.93
Tabulating rentals, equipment, etc.   82,080.69
Automobiles and accessories   14,445.72
Hospital surveys  $9,929.61
Less recovered  28,074.03
  18,144.42*
Office supplies and general  141,735.74
Office furniture and equipment  92,940.68
Postage   46,747.05
Rentals and maintenance   71,258.91
Travelling expenses   31,021.12
Upkeep of automobiles   11,353.15
     $1,908,575.84
Payments to hospitals—claims      17,114,825.31
19,023,401.15
Excess of revenue receipts over disbursements for the fiscal year ended March 31st,
1952    $46,321.32
* Credit.
The Statement of Revenue Receipts and Disbursements for the fiscal year ended March 31st,
1952, together with the Statement Showing Cash Reconciliation with the Public Accounts of the
Province of British Columbia as at March 31st, 1952, show the cash transactions only of the Hospital
Insurance Fund for the period according to the books of the Province.
J. A. CRAIG, C.A.,
Comptroller-General, Province of British Columbia. HOSPITAL INSURANCE SERVICE REPORT,  1952 NN  17
STATEMENT SHOWING CASH RECONCILIATION WITH THE PUBLIC ACCOUNTS
OF THE PROVINCE OF BRITISH COLUMBIA AS AT MARCH 31st, 1952
Period ended March 31st, 1949 (Public Accounts, page
215)     $5,305,908.18
Less financed by Provincial loans and grants—
Hospital Insurance Stabilization
Fund         $50,000.00
"Amusements Tax Act "      1,445,573.40
     1,495,573.40
Operating receipts over disbursements     $3,810,334.78*
Fiscal year ended March 31st, 1950, disbursements over
receipts (Public Accounts, page 147)   $4,550,580.32
Add financed by Provincial loans and grants—
Hospital Insurance Stabilization
Fund   $1,950,000.00
" Revenue   Surplus   Appropriation Act, 1950"      2,500,000.00
$4,450,000.00
"Amusements Tax Act " (fiscal
year 1949 above)      1,445,573.40
     3,004,426.60
Operating disbursements over receipts      7,555,006.92
Fiscal  year  ended   March   31st,   1951,   disbursements   over  receipts
(Public Accounts, page 144)      5,118,697.76
Fiscal year ended March 31st, 1952, receipts over disbursements, fiscal
year 1951-52 (Public Accounts, page 99)   46,321.32*
Operating disbursements over receipts,  1949-52   $8,817,048.58
Add balance at March 31st, 1952—
Amount adjusted on advance to hospitals  ____ $2,552,803,571
Credit balance, Hospital Insurance Fund      4,781,450.99
     2,228,647.42
  $11,045,696.00
Financed by Provincial loans and grants—
Hospital Insurance Stabilization Fund—
Public Accounts 1948-49, page 210         $50,000.00
Public Accounts 1949-50, page 134      1,950,000.00
 $2,000,000.00
" Revenue Surplus Appropriation Act,  1950 " (Public Accounts,
1949-50, page 134)      2,500,000.00
Amount voted under Vote 118, 1950-51      2,545,696.00
" Revenue Surplus Appropriation Act,  1951 " (Public Accounts,
1950-51, page 144)      1,500,000.00
Amount   voted   under   Vote   124,    1951-52   (Public   Accounts
1951-52, page 99)     2,500,000.00
•     11,045,696.00
•Credits. t 1950-51, $1,934,062.62;   1951-52, $618,740.95. NN  18
BRITISH COLUMBIA
Table Ia.—Patients Discharged and Days of Care in B.C. Public Hospitals,
1949-52, and Proportion Covered by B.C. Hospital Insurance Service
Total Hospitalized
Covered by B.C.H.I.S.1
Adults and
Children
New-born
Total
Adults and
Children
New-born
Total
Patients discharged—
1949                      	
164,964
172,225
181,709
187,856
26,272
26,195
27,062
28,511
191,236
198,420
208,771
216,367
140,168
144,959
150,116
154,353
84.9
84.1
82.6
82.2
1,430,646
1,476,615
1,467,102
1,568,740
85.0
83.7
81.0
81.4
1
1
24.640    1        164.808
1950   	
23,943
24,172
25,013
93.8
91.4
89.3
87.7
200,585
193,307
187,891
184,780
93.8
90.8
87.8
86.1
168,902
19512    	
174,288
1952           	
179,366
Percentage of total, patients discharged—
1949                	
86.2
1950
85.1
1951-             	
83.5
1952
82.9
Patient-days—
1949                     	
1,682,196
1,763,722
1,811,219
1,926,168
213,874
212,979
214,037
214,494
1,896,070
1,976,701
2,025,256
2,140,662
1,631,231
1950          	
1,669,922
19512.	
1952              	
1,654,993
1,753,520
Percentage of total, patient-days—
1949
86.0
1950
84.5
19512
81.8
1952        	
81.9
1 B.C.H.I.S. excludes Workmen's Compensation Board patients and days.
2 Amended as per final reports received from hospitals.
Table Ib.—Percentage of Patients Covered by B.C. Hospital
Insurance Service during 1952
Patients charged to agencies—Workmen's Compensation Board, approved insurance plans, and
Federal Government     	
Self-responsible—non-B.C. residents   _ —    	
Subject to B.C.H.I.S. coverage   —       	
Per Cent
8.2
1.1
90.7
100.0
B.C.H.I.S. patients hospitalized (82.9 per cent of total, see Table Ia) in relation to proportion
of patients subject to insurance coverage  (90.7 per cent, see Table Ib)        91.4
Table IIa.—Patients Discharged, Total Days' Stay, and Average Length of
Stay According to Type and Location of Hospital, and Days of Care per
Thousand of Covered Population for B.C.H.I.S. Patients Only, Years 1949
to 1952.
Total
Adults and
Children
Newborn
B.C. Public
Hospitals
Adults and
Children
Newborn
B.C. Private
Hospitals
Adults and I
Children  I
Newborn
Institutions
outside B.C.
Adults and     New-
Children       born
I
Patients discharged—
1949 	
1950   	
195U	
1952     ,	
Patient-days—
1949 	
1950 . 	
19511...... 	
1952  	
Average days of stay-
1949 	
1950  	
1951 .**	
1952 	
149,280
154,643
159,739
164,252
1,498,121
1,564,222
1,551,954
1,661,471
10.03
10.11
9.71
10.11
24,989
24,336
24,587
25,509
203,197
196,333
190,948
188,809
8.13
8.07
7.76
7.40
140,168
24,640
144,959
23,943
150,116
24,172
154,353
25,013
1,430,646
200.585
1,476,615
193,307
1,467,102
187,891
1,568,740
184,780
10.21
8.14
10.19
8.07
9.77
7.77
10.16
7.39
7,093
7,617
7,308
7,277
151
173
171
175
45,960 | 1,146
65,326 j 1,288
62,771 I 1,155
68,782 j 1,086
6.48
8.58
8.59
9.45
7.59
7.44
6.75
6.20
2,019
2,067
2,315
2,622
21,515
22,281
22,081
23,949
10.66
10.78
9.54
9.13
198
220
244
321
1,466
1,738
1,902
2,943
7.40
7.90
7.79
9.17
1 Amended as per final reports received from hospitals.
Estimated days per thousand ot population covered by B.C. Hospital Insurance Service:   1949, 1,540;   1950, 1,566;
1951, 1,500;   1952, 1,542. HOSPITAL INSURANCE SERVICE REPORT,  J 952
NN  19
Table IIb.—Summary of the Number of B.C.H.I.S. In-patients and
Short-stay Patients, 1949-52
1949
1950
19511
1952
Total
Total adults, children, and new-born in-patients • 	
174,269
29,000
178,979
44,502
184,326
47,656
189,761
44,097
727,245
165,255
Total receiving benefits _ ______
203,269
223,481
231,982
233,858
892,500
1 Amended as per final reports received from hospitals.
Table III.—Patients Discharged, Total Days' Stay and Average Length of Stay
in B.C. Public Hospitals for B.C.H.I.S. Patients Only, Grouped According
to Bed Capacity, Year 1952.
3ed Capacit.
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Patients discharged—
154,353
25,013
1,568,740
184,780
10.16
7.39
68,937
9,813
822,596
79,346
11.93
8.09
17,750
2,664
172,235
18,681
9.70
7.01
1
1
40.059    1      14.835
8.840
3,932
8,441
2,286    |        1,473
336
Patient-days—
Adults and children  	
347,508
58,264
8.67
6.90
1
120,714    1      63,043
16.148     I       10.206
42,644
2,135
Average days of stay—
8.14
7.06
7.13
6.93
10.85
New-born	
6.35
Table IV.—Percentage Distribution of Patients Discharged and Patient-days
for B.C.H.I.S. Patients Only, in B.C. Public Hospitals, Grouped According
to Bed Capacity, Year 1952.
Bed Capacity
Total
250 and
Over
100 to 249
50 to 99
25 to 49
Under 25
Special
Patients discharged—
Per Cent
100.00
Per Cent
44.66
Per Cent
11.50
I
Per Cent   |   Per Cent
25.95    |          9.61
33.75     1           9.14
Per Cent
5.73
5.89
Per Cent
2.55
100.00
100.00
100.00
39.23
52.44
42.94
10.65
10.98
10.11
1.34
Patient-days—
22.15
31.53
7.69
8.74
1
4.02    j          2.72
5.52    1           1.16
In Tables III and IV those public hospitals in which B.C. Hospital Insurance Service
does not cover certain types of hospitalization have been shown under the heading
" Special."   The figures, however, include only B.C.H.I.S. patients. NN 20
BRITISH COLUMBIA
BENEFITS IN B.C. HOSPITALS,  1952
The general hospital services to be provided shall include such of the following
services as are recommended by the attending physician and as are available in the hospital to which the person is admitted as an in-patient and when there is definite medical
necessity for in-patient care: —
(a)   Public-ward accommodation:
(_.) Operating-room facilities, including the use of all equipment and material
required in the proper care of surgical cases:
(c) Case-room facilities, including the use of all equipment and material
required in the proper care of maternity cases:
(d) Surgical dressings and casts as required, as well as other surgical materials
and the use of any equipment which may be required while in hospital:
(e) Anaesthetic supplies and the use of anaesthesia equipment:
(f) All other services rendered by individuals who receive any remuneration
from the hospital, provided that the provision of such services in a particular hospital is approved by the Commissioner. Services which may
be approved by the Commissioner for the purpose of this section may
include:—
(1) Radiological, diagnostic, and therapeutic services, including the
services of a radiologist:
(2) Clinical laboratory and other diagnostic procedures, including
the services of a pathologist:
(3) Physiotherapy services:
(g) Care of the acute stage of chronic diseases where, in the opinion of the
Commissioner, such care is necessary and desirable. Such chronic disease
shall include cardiac disease, tuberculosis, mental disease, and acute
anterior poliomyelitis, the acute stage of venereal disease only where
general hospital care is recommended by the Division of Venereal Disease
Control; the acute stage of drug addiction where overdosage and poisoning
have to be given prompt treatment; and the acute stage of alcoholism,
provided in the case of acute alcoholism that hospitals establish under
their own by-laws the conditions under which such persons may be admitted to hospital:
(/i) Such drugs and related preparations listed in the British Columbia Formulary and such other preparations as the Commissioner may from time to
time prescribe. HOSPITAL INSURANCE SERVICE REPORT,  1952 NN 21
CLASSES OF PERSONS COVERED BY OR EXCLUDED FROM THE
BENEFITS OF THE HOSPITAL INSURANCE SERVICE
A. Covered by the Plan upon Payment of the Required Premium
Every person who is a resident of the Province, except persons classified in Groups
B and C hereunder. Participation in the plan is compulsory, except for those in the far
northern areas, who may voluntarily pay premiums and be entitled to benefits.
B. Covered by the Plan by the Provincial Government
1. Those old-age security recipients and recognized dependents who were in receipt
of an old-age pension on December 31st, 1951, together with those persons who apply
to the Provincial Department of Health and Welfare and who are granted free health
services.
2. Old-age assistance cases, blind pensioners, and their dependents.
3. Mothers' Allowance cases, and their dependents.
4. Social Allowance cases to which the Provincial Government contributes financially.
5. Child Welfare cases (wards only).
C. Excluded from the Operation of the Plan
1. Members of the Canadian Armed Forces (but not their dependents).
2. Members of the Royal Canadian Mounted Police (but not their dependents).
3. Students in training under the Department of Veterans' Affairs (but not their
dependents).
4. Veterans in receipt of war veterans' allowance (but not their dependents).
5. Members of the Christian Science Church and residents in certain far northern
regions of the Province who have claimed, and been granted, exemption. Such persons,
if they pay premiums voluntarily, are entitled to the benefits under the Act.
6. A person who is a patient or an inmate of an institution maintained by the
Province.
7. Persons in a Provincial T.B. sanatorium.
8. Employees of the Canadian Pacific Railway and B.C. Telephone Company, who
operate the only private plans approved under the Act.
9. Persons committed to a gaol or penitentiary.
BENEFITS IN HOSPITALS OUTSIDE BRITISH COLUMBIA
Payments for hospital services rendered by hospitals outside the Province of British
Columbia to persons who are beneficiaries under the Act shall be made on the basis of
not more than $8 per day (new-borns, $3.50 per day) and for a period of time not to
exceed thirty days. Payments for a longer period of time than thirty days may be
authorized by the Commissioner where he is satisfied that further care of a type provided
for under the Act is required.
Where a beneficiary produces receipts showing that he has himself paid an account
to a hospital situated outside the Province, he may be reimbursed within the limitations
and subject to the conditions provided in the regulations under the Act.
victoria, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1953
970-253-9838     

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